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No difference between single and staged posterolateral corner surgical procedures in the multiligament injured/dislocated knee

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Posterolateral corner (PLC) injuries commonly occur in the setting of a dislocated knee and often require multiple procedures due to concomitant vascular, nerve, and soft tissue involvement. Debate persists regarding single vs staged surgery. The purpose of this study was to compare knee function after single and staged surgery for PLC injury.

Methods

Patients who underwent surgery for a PLC injury (KD I, IIIL, IV) with minimum follow-up of 2 years were included. Patients treated with staged and single surgery were matched according to age, sex, and KD grade. Lysholm and International Knee Documentation Committee (IKDC) subjective scores were obtained. Risk factors for poor knee function were assessed, including age, nerve, vascular, meniscal and articular cartilage injuries.

Results

Twenty single-surgery patients with a median age of 24 years (median follow-up 5.3 years, range 2–18.3) and 20 staged surgery patients with a median age of 26 years (median follow-up 4.3 years, range 2–19.8) were studied. The mean Lysholm score was 78.7 (± 20.3) in the single surgery and 84.2 (± 17.8) in the staged surgery cohort (n.s.). The mean IKDC score was 80.8 (± 21.1) in the single and 74.9 (± 18.9) in the staged surgery cohort (n.s.). Age at injury, peroneal, vascular, meniscal or cartilage injury were not associated with poor knee outcome.

Conclusion

This study demonstrates similar knee function among patients with PLC injuries treated with single or staged surgical procedures. The need for staged surgery for the dislocated knee with PLC involvement should be individualized based on specific knee and patient-related factors.

Level of evidence

III.

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Funding

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Authors and Affiliations

  1. Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, 55905, USA

    Benjamin Freychet, Nicholas I. Kennedy, Thomas L. Sanders, Nathan M. Levy, Devin P. Leland, Aaron J. Krych, Michael J. Stuart & Bruce A. Levy

Authors
  1. Benjamin Freychet
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  2. Nicholas I. Kennedy
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  3. Thomas L. Sanders
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  4. Nathan M. Levy
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  5. Devin P. Leland
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  6. Aaron J. Krych
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  7. Michael J. Stuart
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  8. Bruce A. Levy
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Correspondence to Bruce A. Levy.

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The authors declare that they have no competing interests. Some individual authors do function as paid consultants for various orthopaedic device companies which did not affect the content or direction of this publication.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Freychet, B., Kennedy, N.I., Sanders, T.L. et al. No difference between single and staged posterolateral corner surgical procedures in the multiligament injured/dislocated knee. Knee Surg Sports Traumatol Arthrosc 28, 2170–2176 (2020). https://doi.org/10.1007/s00167-019-05759-x

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